osteoporosis

Question 1

definition

Answer 1

loss of bone mass / loss of bone mineral density of less than 2.5 standard deviations below young adult mean density

Question 2

major risk factors

Answer 2

corticosteroid use
smoking
alcohol
low body mass index
family history
RA
hip fracture

Question 3

what is FRAX

Answer 3

used to assess a patient’s 10 year risk for a fracture

Question 4

who is assessed for a risk of fracture ?

Answer 4

all women aged >= 65
all men aged >= 75 years

Question 5

when is a DEXA scan recommended over FRAX

Answer 5

before starting treatment that reduces bone density
those aged 40 and under with a major risk factor ( fragility fracture, major fracture, high dose systemic steroids)

Question 6

what is the management of patients > 65 at risk of corticosteroid induced osteoporosis

Answer 6

bone protection

Question 7

what is the management of patients < 65 at risk of corticosteroid induced osteoporosis

Answer 7

bone density scan with bone protection starting when t score < -1.5

Question 8

management of osteoporosis

Answer 8

correct calcium and vitamin D deficiencies.
bisphosphonates - alendronate and risendronate

raloxifene 2nd line

Question 9

t score between 0 and -1.5

Answer 9

repeat scan in 1-3 years